Study compares prevalence, impact of chronic pain amongst different ethnic groups in Tower Hamlets

A new study in the London Borough of Tower Hamlets, funded by medical research charity Arthritis Research UK, may help improve GPs’ understanding of chronic musculoskeletal pain amongst different ethnic groups and develop better strategies for self-management as a result.

The two-year study is the first of its kind to directly compare the prevalence and characteristics of chronic pain in White and Bangladeshi people living in the same geographical area and attending the same GP surgeries.

The prevalence and impact of chronic pain is known to differ between ethnic groups with previous research identifying a need for better management of chronic pain across ethnic groups.

Researchers from the Queen Mary University of London looked at whether the features and effects of chronic pain are similar or different in the Bangladeshi and White populations living in Tower Hamlets. The results of a sample of 4,480 patients registered at 16 general practices in the area showed that chronic pain is both more common and more severe in people who grew up in Bangladesh than in either British Bangladeshis who grew up in the UK, or the White British. However, quality of life was adversely affected by chronic pain in all ethnic groups. People with chronic pain were six times more likely to have poor quality of life than those with no pain. Chronic pain was very common in all three groups, occurring in 50 per cent of Whites and British Bangladeshis and over 70 per cent of people who grew up in Bangladesh.

Around 10 million people in the UK struggle with chronic pain almost every day resulting in a major impact on their quality of life and more days off work (British Pain Society). Chronic pain, defined as pain being present for three months or more, also represents a major challenge to GPs and places a large cost burden on the health service. However, research shows that chronic pain may be preventable and that GPs have an important role in its assessment, management and treatment.

Pain relieving drugs are the most common treatments for chronic pain whilst other treatments can include physical and occupational therapy, psychological treatments such as counselling, and treatment of other illnesses such as depression.

Lead researcher, Professor Martin Underwood, who originally started the project at Queen Mary University of London but has now moved to Warwick Medical School said: “It has been suggested through previous research that pain can be more common in South Asians than Whites and that South Asians living in the UK have different ways of communicating their pain to health professionals and to their families.”

“But the challenge for us was determining the impact of chronic pain in different ethnic communities living in a deprived area of East London. We found that chronic pain was very common and had a major adverse effect on quality of life in all the groups we tested, and have shown for the first time that there are important differences in the health impact of chronic pain between Bangladeshis who grew up in the UK and those who grew up in Bangladesh. Next, we plan to explore the reasons for these differences. This is important in designing services that are appropriate and effective for all patients suffering from chronic pain.”

Dr Tom Margham, GP lead at Arthritis Research UK and a practising GP in Tower Hamlets, said: “Living with chronic pain can be a devastating experience and steals quality of life from too many people in the UK. While some people are able to manage their pain effectively, others become isolated and suffer from a reduced quality of life. This new study gives a real insight into the large numbers of people living with long-term pain in the area where I work and the impact it has on different ethnic groups. Understanding the burden of disease in a local area should help those delivering care and commissioning services in their planning to improve outcomes for people affected by chronic pain”.